Circulation, Vol 84, 2135-2145, Copyright © 1991 by American Heart Association
M Hori, M Kitakaze, H Sato, S Takashima, K Iwakura, M Inoue, A Kitabatake and T Kamada
BACKGROUND. Acidosis during early reperfusion is reported to be beneficial
for myocardial stunning. We tested in 31 dogs the hypothesis that staged
reperfusion is beneficial to myocardial stunning. METHODS AND RESULTS.
Contractile dysfunction was observed 3 hours after the onset of reperfusion
after 15 minutes of occlusion of the coronary artery. In the staged
reperfusion, pH of the coronary venous blood was lower for 20 minutes and
fractional shortening was significantly improved compared with the control
reperfusion group. When we increased pH of the reperfused myocardium by an
intracoronary infusion of sodium bicarbonate, beneficial effects of the
staged reperfusion were abolished. Furthermore, an intracoronary infusion
of hydrogen chloride, which mimicked the changes in pH in coronary venous
blood of the staged reperfusion, attenuated myocardial stunning.
CONCLUSIONS. These results indicate that acidosis during staged reperfusion
primarily attenuates myocardial stunning. This procedure is clinically
applicable for attenuation of reperfusion injury.
ARTICLES
Staged reperfusion attenuates myocardial stunning in dogs. Role of transient acidosis during early reperfusion
First Department of Medicine, Osaka University School of Medicine, Japan.
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